Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Job Classification

In most duration tables, five job classifications are displayed. These job classifications are based on the amount of physical effort required to perform the work. The classifications correspond to the Strength Factor classifications described in the United States Department of Labor's Dictionary of Occupational Titles. The following definitions are quoted directly from that publication.

Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Nosebleed and Control of Nosebleed


Related Terms

  • Epistaxis

Differential Diagnosis

  • Disseminated intravascular coagulopathy (DIC)
  • Granulomatous disease
  • Hemophilia
  • Hemorrhagic telangiectasia
  • Idiopathic thrombocytopenia purpura (ITP)
  • Leukemia
  • Liver failure
  • Nasal malignancy
  • Nasopharyngeal malignancy
  • Polycythemia vera
  • Vitamin K deficiency
  • von Willebrand's disease

Specialists

  • Emergency Medicine Physician
  • Hematologist
  • Internal Medicine Physician
  • Otolaryngologist

Comorbid Conditions

  • Clotting disorders
  • Hypertension

Factors Influencing Duration

Length of disability depends on the severity of the epistaxis, underlying condition, treatment required, and any complications secondary to necessary treatment.

Medical Codes

ICD-9-CM:
21.01 - Operations on Nose; Control of Epistaxis by Anterior Nasal Packing
21.02 - Operations on Nose; Control of Epistaxis by Posterior and Anterior Packing
21.03 - Operations on Nose; Control of Epistaxis by Cauterization and Packing
21.04 - Operations on Nose; Control of Epistaxis by Ligation of Ethmoidal Arteries
21.05 - Operations on Nose; Control of Epistaxis by Transantral Ligation of the Maxillary Artery
21.06 - Operations on Nose; Control of Epistaxis by Ligation of the External Carotid Artery
21.07 - Operations on Nose; Control of Epistaxis by Excision of Nasal Mucosa and Skin Grafting of Septum and Lateral Nasal Wall
21.09 - Operations on Nose; Control of Epistaxis by Other Means
784.7 - Nosebleed (Epistaxis)

Treatment

The goal of treatment is to stop the bleeding and prevent recurrences. For anterior bleeding, direct pressure is applied to the bleeding site by squeezing the nostrils against the septum. If the bleeding does not stop with 15 minutes of direct pressure, the site of the bleed must be identified. Procedures used to visualize the bleeding site include examination through the nostrils (anterior rhinoscopy) and use of an illuminated instrument (nasal endoscopy). Solutions may be used that cause vasoconstriction or stop the bleeding of the blood vessels in the nose. If necessary, the bleeding site may be cauterized by electric cautery. Local anesthetic is used.

When pressure or cauterization is unable to control the bleeding, it may be necessary to pack the nasal passages. Both anterior and posterior bleeding can be packed. Packing may be performed with long strips of gauze or nasal tampons or sponges. When packing is placed, antibiotic coverage is necessary to prevent sinusitis and toxic shock syndrome. Analgesics may also be prescribed, if needed.

Cauterization is not recommended if bleeding is due to bleeding abnormalities because the procedure itself may cause bleeding. In this case, petrolatum gauze packing is applied. If recurrent bleeding is from a deviated septum, surgical correction (septoplasty) may be required. Anterior nasal packing is left in place for 2 to 3 days and then removed by the physician in an office procedure.

Posterior bleeding is more difficult to control and can be life-threatening. These bleeds usually result from underlying medical conditions such as high blood pressure or bleeding disorders. A surgical posterior rhinoscopy performed by an ear, nose, and throat specialist (otolaryngologist) may be necessary to identify the bleeding site. Nasal endoscopy may also be used to identify the bleeding site.

Procedures to control posterior bleeding include injection of vasoconstrictive medications, packing, placement of a catheter in the nose to provide pressure, placement of balloon devices (similar to that of a catheter but specially made for placement in the posterior nose), cauterization, or binding or tying off of associated nasal arteries (ligation). A neuroradiologist may also perform a procedure in which clotting material is injected into an arterial bleeder in the nose that occludes the artery at the bleeding site (angiographic procedure called angiographic embolization). In extreme cases, bleeding may have to be controlled with surgical correction. Packing is uncomfortable, and often pain and sedative medications are given during the procedure. Antibiotics and analgesics are prescribed while the packing is in place. Angiography may be necessary if surgical packing has not been successful for stopping the nosebleed.

If treatment includes posterior packing, the individual is usually hospitalized for observation of cardiac arrhythmias, respiratory failure, aspiration, cerebral vascular accident (CVA), and hypoxia. Oxygen may be necessary for treatment of hypoxia.

Source: Medical Disability Advisor






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